This invention in general concerns an improved patient support pad, and more particularly concerns a resilient pad for use with prone positioned surgery patients to reduce bleeding of such patients during relatively longer surgical procedures.
Numerous positioning devices of various constructions have been provided in foam materials. For example, SpanAmerica Medical Systems, Inc., of Greenville, S.C., markets a number of different products, some of which are intended for operating room use, and others which can be used in more general patient care settings. Such products include an operating room prone pillow and a physical therapy prone pillow which have foam engagement support surfaces for receiving and supporting a patient's head in a prone position while maintaining an open breathing space just below the patient's nose.
Other operating room products of Span-America include support pads comprising convoluted foam mattresses, and armboard pads, also formed of convoluted material. Still, other products are intended for more specific support and/or positioning functions. For example, a foam donut has an 8 inch diameter with a 4 inch diameter central hole, useful for dispersing pressure such as on the ear of a laterally positioned patient. Another device is a 5 inch diameter cylindrical positioning roll which may be placed where desired for pressure dispersion. Various curved pad products properly align a patient's head, neck, shoulders, spin, or legs.
While the foregoing products are tremendously useful for their intended purposes, they generally are not specifically concerned with reducing the level of bleeding by a patient supported in a prone position for rather lengthy surgical procedures, such as 7 to 15 hours in length. It is generally known that as a patient lies on his or her stomach in a prone position for many hours, the added pressure to the abdominal region and to the patient's vascular system results in a greater profusion of blood to the side of the patient opposite the abdomen (i.e., the back or dorsal side). Excessive bleeding (undesirable in any circumstance) is a particular problem during treatment of certain conditions such as scoliosis (spinal curvatures) during which the surgery patient is confined to a prone position for many hours. The greater profusion of blood in the spinal area is particularly problematic as the surgery progresses.
Various efforts have been made to address this problem. Surprisingly, reduced pressure on the abdomen resulting in less constriction of the vascular system results in reduced bleeding rather than increased bleeding. A so-called "Hall Frame" designed by Dr. John Hall of Boston, Mass., comprises an open frame for receipt and support of a patient in a prone position. Essentially, the frame has rubberized supports which undersling the patient's chest and pubic or hip area so that the patient is suspended (wherefore there is no patient abdominal contact with a primary support surface). While direct pressure to the abdomen is eliminated, such a framework disadvantageously permits the entire spine to drop or sag into a concavity, which is undesired particularly for spinal surgery patients. Also, space and access factors become involved during use of a framework. Manipulation of both the framework and the patient is also a potential negative factor regarding practicality of the Hall Frame.
Another prior attempt to reduce abdomen pressure during surgery is to provide a so-called kneeling table. In general, the patient's upper chest is received onto an operating table, and the patient's hip and knee joints are at respective 90 degree angles to the upper chest so that in effect the patient kneels across the operating table. The arrangement requires the introduction of a board immediately behind the buttocks of the patient for pushing the patient forward so that the abdomen will be suspended by contact of the patient's upper chest with the operating table. Obviously, there is a considerable amount of pressure by such arrangement to the front of the patient's legs, and to the knees. The entire arrangement is less than desirable.
Less extensive and less intrusive approaches to abdomen suspension have been attempted. For example, two semicircles of hard rubber approximately 4 inches thick are available in the marketplace. The semicircles are connected by a strap so that their relative placement is adjustable. Generally the semicircles are positioned as a donut or circle underneath the patient's abdomen to act as a surgical pad. Without any particular contouring and without any particular resilient support of the patient, the usefulness of such a positioning device is limited to relatively short operations, such as of only 1 or 2 hours duration. Pressure problems due to the relatively nonresilient nature of the support are problems in longer operations. Also, with only 4 inches thickness and relative compression of the device, an adult patient's abdomen still could come into contact with an underlying primary support surface, and thereby become compressed. Compression on the abdomen is precisely one of the main problems being sought to be avoided. It has also been known to roll towels or pads and simply place same under the top of the chest or beneath the patient's hip area so as to somewhat suspend the abdomen.